Babies with brain damage who can not swallow: surgical management.
BACKGROUND
Neonates with severe neurological impairment are often unable to swallow, necessitating gastrostomy for feeding. Because of the risk of developing severe reflux, this procedure is often associated with fundoplication.


OBJECTIVE
To assess the safety and efficacy of gastrostomy and Nissen fundoplication in 22 neonates with swallowing difficulties due to serious neurological impairment.


METHODS
All children underwent an initial period of nasogastric feeding and after informed consent underwent gastrostomy and Nissen fundoplication.


RESULTS
There were no significant intraoperative complications. There were two cases of postoperative periostomy leakage. Of the 22 neonates 16 were alive four months after surgery. Six neonates died of complications due to underlying disease.


CONCLUSIONS
We concluded that gastrostomy and Nissen fundoplication are safe procedures and help parents give a better care to these children.
Silva
Sidney V da
SV
Section of Neonatology, Department of Pediatrics Campinas State University, Campinas SP, Brazil.
Schmidt
Augusto F S
AF
Mezzacappa
Maria A
MA
Marba
Sérgio T
ST
Bustorff-Silva
Joaquim M
JM
Sbragia
Lourenço
L
D001925:Brain Damage, Chronic / Q000150:complications*; D003680:Deglutition Disorders / Q000209:etiology* / Q000601:surgery; D005260:Female; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies